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Case Report

JCDR. 2013; 4(1): 65-67


Severe hypertension in elapid envenomation

Ramachandran Meenakshisundaram, Subramanian Senthilkumaran, Martin Grootveld,Ponniah Thirumalaikolundusubramanian.


Abstract

Snakebite is not an uncommon medical emergency in India; however, symptoms of autonomic
dysfunction in snakebite are rare. The elapid snake envenomation is a frequent occurrence in India, and
the krait bite is prevalent in the south Indian region. Here, we present three cases of snakebite with
severe hypertension and requiring intravenous nitroglycerin (NTG). As the level of blood pressure (BP)
decreased significantly following antisnake venom (ASV) injection in all three cases, it is likely that snake
venom-induced dysautonomia might have contributed to severe hypertension in such patients. Clinical
and therapeutic challenges of these cases are highlighted, so that practitioners coping with medical
emergencies in resource-limited situations can consider snake (krait) bite in the differential diagnosis,
and also manage effectively according to corroborative clinical evidences.

Key words: Elapid Hypertension Krait Snakebite






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